Patrons:
Justice Elizabeth Evatt AO
Professor William Maley AM
COMPANION HOUSE SUBMISSION TO PRODUCTIVITY COMMISSION INQUIRY INTO THE NATIONAL DISABILITY INSURANCE SCHEME COSTS
March 2017
Introduction
Companion House is a non-government community based organisation in the ACT. We work with adults and children who have sought safety in Australia from persecution, torture and war related trauma. We believe that people who have survived torture, trauma and human rights violations should have access to services that respect, empower and promote recovery. Our services include medical, counselling, community development, training and policy advice and advocacy.
Some of our clients experience disability, including physical disabilities and mental health issues. A small number are NDIS participants, or have applied to become an NDIS participant and are waiting for their claim to be assessed.
This submission briefly summarises our experience to date in assisting our clients to access the NDIS in the ACT. Below are some general issues, and then we address some of the questions outlined in the Productivity Commission Issues paper on NDIS costs.
Issues
Companion House staff has assisted some clients living with disability to become NDIS participants. The choice and control that these individuals now have in their lives is an enormous step forward for them.
Our experience to date leads us to make the following observations about the operation of the NDIS in the ACT for our client group, including recommendations for improvement.
Newly arrived refugees have little or no understanding of the NDIS and usually have limited English language skills. They may have disability, including severe and profound, but have not been assessed through existing ACT disability system and so are not linked into existing services. Our experience is that it takes up to 12 months to go through the process of applying for the NDIS. During this time, it is difficult for clients with disability to access any support or treatment when the block funded disability services are being disbanded and Therapy ACT is unable to take new referrals. There is a distinct gap in disability services for newly arrived people.
RECOMMENDATION 1: The NDIA consider ways to address the current lack of support for people with disability who are not linked into existing services and who are in the process of applying for the NDIS.
Companion House Assisting Survivors of Torture and Trauma Inc.
41 Templeton Street COOK ACT 2614 Telephone: (02) 6251 4550 Fax: (02) 6251 8550
Mailing Address: PO BOX 112 Jamison Centre ACT 2614
Email: info@companionhouse.org.au Website: http://www.companionhouse.org.au
Specific Questions from the Issues Paper
Is the planning process valid, cost effective, reliable, clear and accessible?
We observe a lack of consistency between the approaches of different assessors. We note that some of this may be expected given the ACT was a trial site. When assessors take time to use interpreters and seek to understand the individual needs of each client, outcomes are more appropriately tailored, rather than an assessor assuming they know what is needed by a person just because they have a particular diagnosis or condition. Assessors need to understand diversity and cultural differences among NDIS applicants, rather than assuming ‘one size fits all’.
The NDIA appears to be limiting interpreter funding in support packages, particularly this year. We are aware of clients who did not get any interpreter funding and the agency providing support coordination finds it extremely difficult to communicate with participants and provide appropriate services.
In one case a bicultural worker from Companion House provided all the interpreting services for assessment, planning and some service delivery. Service providers involved had no links to interpreting services, policies around using interpreters or skills in this area.
Planning also needs to take account of the family context of the individual, such as their child care and any other caring responsibilities which may impact on their ability to take time participate socially and economically.
RECOMMENDATION 2: Assessors and planners approach each applicant as an individual with unique needs and situation, including those from culturally and linguistically diverse backgrounds who do not speak English.
RECOMMENDATION 3: Adequate interpreter funding in support packages be provided according to the need of individuals.
How well equipped are NDIS eligible individuals (and their families and carers) to understand and interact with the scheme, negotiate plans, and find and negotiate supports with providers?
People with disability from a refugee background are often not well equipped to navigate the NDIS in planning meetings and to negotiate a package of supports from providers. Many have little or no understanding of the context of the broader social support system in Australia. It is difficult for them to interact with the NDIS as it is a complex scheme.
At many points in this service system interpreters have not been offered, providing a fundamental barrier to interaction with the system.
Our experience is that it is critical for people from a refugee background with disability to have an advocate to assist them through the process of applying for support, particularly during the planning meeting but also in other interactions with the NDIA and in negotiating with support providers. Companion House staff have played this role for our clients, although we are not directly funded for this. Given our lack of specialist expertise in the NDIS, we have also on occasion sought support from an NDIS service coordinator to assist in navigating the planning process particularly.
Our staff find it hard to communicate directly with assessors at the NDIA who understand an individual case. This is important in all our advocacy work and particularly frustrating when we need to understand why a client living with disability has their application to participate in the NDIS rejected.
As far as we are aware, the NDIA does not have dedicated support services for refugee clients. We see a role for a dedicated liaison officer for culturally and linguistically diverse applicants and participants, similar to Centrelink’s Multicultural Service Officers.
RECOMMENDATION 4: The NDIA consider introducing specialist multicultural service officers, similar to the existing system in Centrelink. Their role would be to build up expertise within the NDIA in addressing the needs of CALD communities and be the main point of contact for refugee and migrant support agencies.
What are the best mechanisms for supplying thin markets? Will providers be able to deliver supports that meet the culturally and linguistically diverse needs of scheme participant?
Providers will be better able to provide supports for non English speaking clients if sufficient funds for interpreters are provided in package. In some cases it may be preferable for supports to be provided by people from within the individual’s own community. While in theory participants could purchase services from within their own community, the administrative burden involved means this is likely to be impractical for some clients.
RECOMMENDATION 5: Investigation of further design possibilities which could enhance the potential of people utilising support from within their own communities.